Phototherapy in Pigmentary Disorders

Abstract

Phototherapy is an important treatment for pigmentary problems, in particular, for vitiligo, which is a common acquired depigmenting skin disease. PUVA therapy, both topical and systemic, has been a mainstay of treatment for years. However, PUVA is associated with an increase in skin malignancies especially with high cumulative sessions of phototherapy. In recent years, NBUVB and the excimer laser/lamp have become increasingly used as the main treatment modalities for vitiligo. The efficacy, relative ease of administration and lower skin carcinogenic risk have made these treatments the phototherapy treatment of choice. NBUVB is widely used for full body phototherapy, but targeted NBUVB devices are also available. Phototherapy with home hand-held phototherapy units has also been shown to have good efficacy with better adherence to treatment. The excimer laser and lamp emit UV light at wavelength of 308 nm and deliver targeted phototherapy. The phototherapy modalities can be combined with other modalities of treatment such as topical calcineurin inhibitors and calcipotriol for greater efficacy. Phototherapy still remains an important, safe and effective treatment for vitiligo.